By Steven J. Yelton
I have mentioned in this column before that I have an interesting position in that I am a Healthcare Engineering Technology professor, a senior clinical engineering consultant for the Christ Hospital Health Network in Cincinnati, Ohio and an AAMI board member. In these roles, I am constantly interested in “The Future” as it relates to Healthcare Engineering Technology and how it affects technicians. In all of these areas, the common theme that presents itself is that we must take a “systems approach” in order to be successful and highly effective in the future.
I wrote a previous column on “The CE-IT Technician” and now I see a similar relationship with Clinical and Systems Engineering, therefore I ask the question: “The CE-SE Technician?” I am currently updating job descriptions in my position as senior consultant and what sticks out to me in doing this is that we are no longer referring to “medical devices” in our job descriptions. We are now referring to “medical systems” almost exclusively. My colleague Greg Herr, Director of Clinical Engineering at the Christ Hospital Health Network, has commented to me that he has seen the shift from managing stand-alone medical devices to medical systems that are integrated. This is a common message that I hear from many Healthcare Technology Management (HTM) professionals.
AAMI is currently working with the International Council on Systems Engineering (INCOSE ) to figure out how the two organizations may effectively work together to advance the systems thinking approach to HTM.
In our roles as biomedical technicians and clinical engineers, we are working daily with interconnected systems. In troubleshooting a medical system, we must determine if the problem is related to component failure, software issues, network communications, issues with interconnected systems, etc. We are troubleshooting a mix of many systems, a “system of systems” if you will or any other trendy term that you may have heard lately. My feeling is that we are applying systems engineering approaches without realizing it in many, or even most, cases.
As educators, we are always looking for what skills our students need to possess in order to attain gainful employment upon graduation. In my opinion most of us are teaching systems troubleshooting in places within our curriculums, but I also feel that we must continue to expand this approach throughout our curriculums.
As I mentioned in “The CE-IT technician” column: According to AAMI’s “Core Competencies for the HTM Entry-level Technician: A Guide for Curriculum Development in Academic Institutions,” in addition to their training in biomedical systems, electronics, digital and microprocessor systems, telecommunications, etc., biomedical technology students should attain training in the area of installation and maintenance of computer networks, security of networks, technologies such as “Voice over IP, business communication systems, as well as training in the areas of HIPAA regulations, HL7 protocols, and device integration with the electronic medical record to name a few. This is considered basic IT knowledge needed by biomedical technicians today. As a reminder, this is a nationally vetted guide and it shows specifically how biomeds are working with systems. I feel that this shows us specifically that we must be able to troubleshoot a “system of systems” just by virtue of the vast array of competencies that the BMET must possess.
In the March/April 2013 issue of Biomedical Instrumentation and Technology, “All Systems Go, How Systems Engineering Can Improve Healthcare Technology,” Herr noted the following 10 changes that he has seen at the Christ Hospital Health Network:
- Device/system integration with EHR;
- Increased software support vs. hardware support;
- Adoption of change management practices;
- Regulation/oversight requirements;
- Closer alignment with IT services and applications;
- New specialists and roles-changes in CE organizational structure;
- Intensity and speed of change;
- Greater visibility in organization;
- Capital planning and selection dependent on systems requirements;
- Balancing traditional clinical engineering roles while moving into new systems roles.
It was also mentioned in the article that “Systems thinking advocates believe there is an emerging, but largely unfilled, need for systems integrators in hospitals and other healthcare delivery organizations.”
Even though these 10 changes are from 2013, I feel that they are still true and relevant today. As educators and/or HTM professionals, we have to make sure that we are striving toward these goals and toward systems level thinking. It is more and more obvious that we are no longer break/fix technicians. We are truly Healthcare Technology Managers from the entry-level biomedical technician on.
Steven J. Yelton, PE, CHTM; is a Senior Consultant for HTM at The Christ Hospital Health Network in Cincinnati, Ohio and a Professor at Cincinnati State Technical and Community College where he teaches biomedical instrumentation courses. He is a member of AAMI’s Board of Directors-Executive Committee, AAMI’s Foundation Board of Directors, Chair of AAMI’s Technology Management Council, Chair of AAMI’s HTAC committee and is a member of the ABET Board of Delegates.